Objective: The nature of disaster research makes it difficult to adequately measure the impact that significant events have on a population. Large, representative samples are required, ideally with comparable data collected before the event. When Christchurch, New Zealand, was struck by multiple, devastating earthquakes, there presented an opportunity to investigate the effects of dose-related quakes (none, one, two or three over a 9-month period) on the cognition of Canterbury’s elderly population through the New Zealand Brain Research Institute’s (NZBRI’s) cognitive screening study. The related effects of having a concomitant medical condition, sex, age and estimated- full scale IQ (Est-FSIQ) on cognition were also investigated. Method: 609 participants were tested on various neuropsychological tests and a self-rated dementia scale in a one hour interview at the NZBRI. Four groups were established, based on the number of major earthquakes experienced at the time of testing: “EQ-dose: None” (N = 51) had experienced no quakes; “EQ-dose: One” (N = 193) had experienced the initial quake in September 2010; “EQ-dose: Two” (N = 82) also experienced the most devastating February 2011 quake; and “EQ-dose: Three” (N = 265) also the June 2011 quake at testing. Results: Two neuropsychological variables of Trail A and the AD8 were impacted by an EQ-dose effect, while having a medical condition was associated with poorer function on the MoCA, Rey Copy and Recall, Trail A, and AD8. Having a major medical condition led to worse performance on the Rey Copy and Recall following the major February earthquake. Males performed significantly better on Trail A and Rey Planning, while females better on the MoCA. Older participants (>73) had significantly lower scores on the MoCA than younger participants (<74), while those with a higher Est-FSIQ (>111) had better scores on the MoCA and Rey Recall than participants with a lower Est-FSIQ. Finally, predicted variable analysis (based on calculated, sample-specific Z-scores) failed to find a significant earthquake effect when variables of age, sex and Est-FSIQ were controlled for, while there was a significant effect of medical condition on each measure. Conclusion: The current thesis provides evidence suggesting resilience amongst Canterbury’s elderly population in the face of the sequence of significant quakes that struck the region over a year from September 2010. By contrast, having a major medical condition was a ‘more significant life event’ in terms of impact on cognition in this group.
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In February of 2011, an earthquake destroyed the only all-weather athletics track in the city of Christchurch (New Zealand). The track has yet to be replaced, and so since the loss of the track, local Christchurch athletes have only had a grass track for training and preparation for championship events. This paper considers what effect the loss of the training facility has had on the performance of athletes from Christchurch at national championship events. Not surprisingly, the paper finds that there has been a deterioration in the performance in events that are heavily dependent upon the all-weather surface. However, somewhat more surprisingly, the loss of the track appears to have caused a significant improvement in the performance of Christchurch athletes in events that, while on the standard athletics program, are not heavily track dependent.
The 22nd February 2011, Mw 6.3 Christchurch earthquake in New Zealand caused major damage to critical infrastructure, including the healthcare system. The Natural Hazard Platform of NZ funded a short-term project called “Hospital Functions and Services” to support the Canterbury District Health Board’s (CDHB) efforts in capturing standardized data that describe the effects of the earthquake on the Canterbury region’s main hospital system. The project utilised a survey tool originally developed by researchers at Johns Hopkins University (JHU) to assess the loss of function of hospitals in the Maule and Bío-Bío regions following the 27th February 2010, Mw 8.8 Maule earthquake in Chile. This paper describes the application of the JHU tool for surveying the impact of Christchurch earthquake on the CDHB Hospital System, including the system’s residual capacity to deliver emergency response and health care. A short summary of the impact of the Christchurch earthquake on other CDHB public and private hospitals is also provided. This study demonstrates that, as was observed in other earthquakes around the world, the effects of damage to non-structural building components, equipment, utility lifelines, and transportation were far more disruptive than the minor structural damage observed in buildings (FEMA 2007). Earthquake related complications with re-supply and other organizational aspects also impacted the emergency response and the healthcare facilities’ residual capacity to deliver services in the short and long terms.
Climate change and population growth will increase vulnerability to natural and human-made disasters or pandemics. Longitudinal research studies may be adversely impacted by a lack of access to study resources, inability to travel around the urban environment, reluctance of sample members to attend appointments, sample members moving residence and potentially also the destruction of research facilities. One of the key advantages of longitudinal research is the ability to assess associations between exposures and outcomes by limiting the influence of sample selection bias. However, ensuring the validity and reliability of findings in longitudinal research requires the recruitment and retention of respondents who are willing and able to be repeatedly assessed over an extended period of time. This study examined recruitment and retention strategies of 11 longitudinal cohort studies operating during the Christchurch, New Zealand earthquake sequence which began in September 2010, including staff perceptions of the major impediments to study operations during/after the earthquakes and respondents’ barriers to participation. Successful strategies to assist recruitment and retention after a natural disaster are discussed. With the current COVID-19 pandemic, longitudinal studies are potentially encountering some of the issues highlighted in this paper including: closure of facilities, restricted movement of research staff and sample members, and reluctance of sample members to attend appointments. It is possible that suggestions in this paper may be implemented so that longitudinal studies can protect the operation of their research programmes.<br /><br />Key messages<br /><ul><li>Recruitment and retention of longitudinal study participants is challenging following a natural disaster.</li><br /><li>The long-lasting, global effects of the Covid 19 pandemic will increase this problem.</li><br /><li>Longitudinal study researchers should develop protocols to support retention before a disaster occurs.</li><br /><li>Researchers need to be pragmatic and flexible in the design and implementation of their studies.</li></ul>
Following a major earthquake event, essential public amenities such as medical facilities and transport networks need to remain functional - not only to fulfil their ongoing role in serving the community but also to cope with the added and immediate demand of a population affected by a natural disaster. Furthermore, the economic implications of wide spread damage to housing and commercial facilities should not be discounted. A shift in design approach is required that is consistent with current trends towards performance based building design. The present aim is to achieve seismic energy dissipation during the earthquake event, without the aftermath of damage to structural elements, whilst maintaining design economies. Structures permitted to rock on their foundations and provide recoverable rotations at the beam-column interfaces offer significant advantages over those using conventional ductile detailing. A jointed construction philosophy can be applied whereby structural elements are connected with unbonded prestressing tendons. Supplemental damping is provided by replaceable flexural steel components designed to deform inelastically. For this research a multi-storey test building of one quarter scale has been constructed and tested on an earthquake simulator at the University of Canterbury. A computer model has been developed and a set ofpreliminary design procedures proposed.
For 150,000 Christchurch school students, the 12.51 pm earthquake of 22 February 2011 shattered their normal lunch time activities and thrust their teachers into the role of emergency first responders. Whether helping students (children) escape immediate danger, or identifying and managing the best strategies for keeping children safe, including provision of extended caregiving when parents were unable to return to school to retrieve their children, teachers had to manage their own fears and trauma reactions in order to appear calm and prevent further distress for the children in their care. Only then did teachers return to their families. Eighteen months later, twenty teachers from across Christchurch, were interviewed. At 12.51pm, the teachers were essentially first responders. Using their usual methods for presenting a calm and professional image, the teachers’ emotion regulation (ER) strategies for managing their immediate fears were similar to those of professional first responders, with similar potential for subsequent burnout and negative emotional effects. Teachers’ higher emotional exhaustion and burnout 18 months later, were associated with school relocation. Lower burnout was associated with more emotional awareness, ER and perceived support. Consistent with international research, teachers’ use of cognitive reappraisal (re-thinking a situation) was an effective ER strategy, but this may not prevent teachers’ emotional resources from eventually becoming depleted. Teachers fulfill an important role in supporting children’s psychosocial adjustment following a natural disaster. However, as also acknowledged in international research, we need to also focus on supporting the teachers themselves.
The Townsend Observatory is located in the Arts Centre of Christchurch, in what used to be Canterbury College (now University of Canterbury). The Townsend telescope itself is a historic 6-inch Cooke refractor built in 1864 for early Christchurch colonist, Mr James Townsend, and gifted by him to Christchurch College in 1891. At the same time, the Canterbury Astronomical Society handed over its funds to the College to help erect an observatory. The College used this, and money it had set aside for a medical school, to build a biological laboratory with an attached observatory tower, which was completed in 1896. The Biology Building and Observatory Tower was the last major design by architect Benjamin Mountfort. Mr Walter Kitson was appointed custodian of the telescope and regular public open nights commenced. and continued until 2010, with the telescope being operated by students of the Department of Physics and Astronomy, University of Canterbury. The Observatory Tower was badly damaged in the 4 September 2010 earthquake and collapsed in the 22 February 2011 earthquake. The telescope was badly damaged by the collapse, but, amazingly, the optics were found entirely intact. The Department of Physics and Astronomy plans to restore the Townsend Telescope so that it can be returned to a replica Observatory Tower in its central city home, enabling the people of Christchurch, and visitors, to enjoy views of the night sky through this beautiful and historic telescope once again.
The Evaluating Maternity Units (EMU) study is a mixed method project involving a prospective cohort study, surveys (two postnatal questionnaires) and focus groups. It is an Australasian project funded by the Australian Health and Medical Research Council. Its primary aim was to compare the birth outcomes of two groups of well women – one group who planned to give birth at a primary maternity unit, and a second group who planned to give birth at a tertiary hospital. The secondary aim was to learn about women’s views and experiences regarding their birthplace decision-making, transfer, maternity care and experiences, and any other issues they raised. The New Zealand arm of the study was carried out in Christchurch, and was seriously affected by the earthquakes, halting recruitment at 702 participants. Comprehensive details were collected from both midwives and women regarding antenatal and early labour changes of birthplace plans and perinatal transfers from the primary units to the tertiary hospital. Women were asked about how they felt about plan changes and transfers in the first survey, and they were discussed in some focus groups. The transfer findings are still being analysed and will be presented. This study is set within the local maternity context, is recent, relevant and robust. It provides midwives with contemporary information about transfers from New Zealand primary maternity units and women’s views and experiences. It may help inform the conversations midwives have with each other, and with women and their families/whānau, regarding the choices of birthplace for well childbearing women.
Interagency Emergency Response Teams (IERTs) play acrucial role in times of disasters. Therefore it is crucial to understand more thoroughly the communication roles and responsibilities of interagency team members and to examine how individual members communicate within a complex, evolving, and unstable environment. It is also important to understand how different organisational identities and their spatial geographies contribute to the interactional dynamics. Earthquakes hit the Canterbury region on September, 2010 and then on February 2011 a more devastating shallow earthquake struck resulting in severe damage to the Aged Residential Care (ARC) sector. Over 600 ARC beds were lost and 500 elderly and disabled people were displaced. Canterbury District Health Board (CDHB) set up an interagency emergency response team to address the issues of vulnerable people with significant health and disability needs who were unable to access their normal supports due to the effects of the earthquake. The purpose of this qualitative interpretive study is to focus on the case study of the response and evacuation of vulnerable people by interagencies responding to the event. Staff within these agencies were interviewed with a focus on the critical incidents that either stabilised or negatively influenced the outcome of the response. The findings included the complexity of navigating multiple agencies communication channels; understanding the different hierarchies and communication methods within each agency; data communication challenges when infrastructures were severely damaged; the importance of having the right skills, personal attributes and understanding of the organisations in the response; and the significance of having a liaison in situ representing and communicating through to agencies geographically dispersed from Canterbury. It is hoped that this research will assist in determining a future framework for interagency communication best practice and policy.
Abstract The original intention for the Partnership Community Worker (PCW) project in 2006 was for it to be an extension of the Pegasus Health General Practice and furthermore to be a bridge between the community and primary healthcare. It was believed that a close working relationship between the Practice Nurse and the PCW would help the target population of Māori, Pacifica and low income people to address and overcome their perceived barriers to healthcare which included: finance, transport, anxiety, cultural issues, communication, or lack of knowledge. Seven years later although the PCW project has been deemed a success in the Canterbury District Health Board annual reports (2013-14) and community and government agencies, including the Christchurch Resettlement Service (2012), many of the Pegasus Health General Practices have not utilised the project to its full extent, hence the need for this research. I was interested in finding out in the first instance if the model had changed and, if so why, and in the second instance if the promotional material currently distributed by Pegasus Health Primary Health Organisation reflected the daily practice of the PCW. A combination of methods were used including: surveys to the Pegasus Health General Practices, interviews with PCWs, interviews with managers of both the PCW host organisations and referring agencies to the PCW project. All the questions asked of all the participants in this research were focussed on their own perception of the role of the PCW. Results showed that the model has changed and although the publications were not reflecting the original intention of the project they did reflect the daily practice of the PCWs who are now struggling to meet much wider community expectations and needs. Key Results: Partnership Community Worker (PCW) interviews: Seventeen PCWs of the 19 employed were interviewed face to face. A number expressed interest in more culturally specific training and some are pursuing qualifications in social work; for many pay parity is an issue. In addition, many felt overwhelmed by the expectations around clients with mental health issues and housing issues now, post-earthquakes. Medical Practice surveys: Surveys were sent to eighty-two Pegasus Health medical practices and of these twenty five were completed. Results showed the full capacity of the PCW role was not clearly understood by all with many believing it was mostly a transport service. Those who did understand the full complexity of the role were very satisfied with the outcomes. PCW Host Community Manager Interviews: Of the ten out of twelve managers interviewed, some wished for more communication with Pegasus Health management because they felt aspects of both the PCW role and their own role as managers had become blurred over time. Referring organisations: Fifteen of the fifty referring community or government organisations participated. The overall satisfaction of the service was high and some acknowledged the continuing need for PCWs to be placed in communities where they were well known and trusted. Moreover results also showed that both the Canterbury earthquakes 2010-2011 and the amalgamation of Partnership Health PHO and Pegasus Health Charitable Limited in 2013 have contributed to the change of the model. Further future research may also be needed to examine the long term effects on the people of Canterbury involved in community work during the 2011-2014 years.
Background: Up to 6 years after the 2011 Christchurch earthquakes, approximately one-third of parents in the Christchurch region reported difficulties managing the continuously high levels of distress their children were experiencing. In response, an app named Kākano was co-designed with parents to help them better support their children’s mental health. Objective: The objective of this study was to evaluate the acceptability, feasibility, and effectiveness of Kākano, a mobile parenting app to increase parental confidence in supporting children struggling with their mental health. Methods: A cluster-randomized delayed access controlled trial was carried out in the Christchurch region between July 2019 and January 2020. Parents were recruited through schools and block randomized to receive immediate or delayed access to Kākano. Participants were given access to the Kākano app for 4 weeks and encouraged to use it weekly. Web-based pre- and postintervention measurements were undertaken. Results: A total of 231 participants enrolled in the Kākano trial, with 205 (88.7%) participants completing baseline measures and being randomized (101 in the intervention group and 104 in the delayed access control group). Of these, 41 (20%) provided full outcome data, of which 19 (18.2%) were for delayed access and 21 (20.8%) were for the immediate Kākano intervention. Among those retained in the trial, there was a significant difference in the mean change between groups favoring Kākano in the brief parenting assessment (F1,39=7, P=.012) but not in the Short Warwick-Edinburgh Mental Well-being Scale (F1,39=2.9, P=.099), parenting self-efficacy (F1,39=0.1, P=.805), family cohesion (F1,39=0.4, P=.538), or parenting sense of confidence (F1,40=0.6, P=.457). Waitlisted participants who completed the app after the waitlist period showed similar trends for the outcome measures with significant changes in the brief assessment of parenting and the Short Warwick-Edinburgh Mental Well-being Scale. No relationship between the level of app usage and outcome was found. Although the app was designed with parents, the low rate of completion of the trial was disappointing. Conclusions: Kākano is an app co-designed with parents to help manage their children’s mental health. There was a high rate of attrition, as is often seen in digital health interventions. However, for those who did complete the intervention, there was some indication of improved parental well-being and self-assessed parenting. Preliminary indications from this trial show that Kākano has promising acceptability, feasibility, and effectiveness, but further investigation is warranted. Trial Registration: Australia New Zealand Clinical Trials Registry ACTRN12619001040156; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=377824&isReview=true
The magnitude 6.2 Christchurch earthquake struck the city of Christchurch at 12:51pm on February 22, 2011. The earthquake caused 186 fatalities, a large number of injuries, and resulted in widespread damage to the built environment, including significant disruption to lifeline networks and health care facilities. Critical facilities, such as public and private hospitals, government, non-government and private emergency services, physicians’ offices, clinics and others were severely impacted by this seismic event. Despite these challenges many systems were able to adapt and cope. This thesis presents the physical and functional impact of the Christchurch earthquake on the regional public healthcare system by analysing how it adapted to respond to the emergency and continued to provide health services. Firstly, it assesses the seismic performance of the facilities, mechanical and medical equipment, building contents, internal services and back-up resources. Secondly, it investigates the reduction of functionality for clinical and non-clinical services, induced by the structural and non-structural damage. Thirdly it assesses the impact on single facilities and the redundancy of the health system as a whole following damage to the road, power, water, and wastewater networks. Finally, it assesses the healthcare network's ability to operate under reduced and surged conditions. The effectiveness of a variety of seismic vulnerability preparedness and reduction methods are critically reviewed by comparing the observed performances with the predicted outcomes of the seismic vulnerability and disaster preparedness models. Original methodology is proposed in the thesis which was generated by adapting and building on existing methods. The methodology can be used to predict the geographical distribution of functional loss, the residual capacity and the patient transfer travel time for hospital networks following earthquakes. The methodology is used to define the factors which contributed to the overall resilence of the Canterbury hospital network and the areas which decreased the resilence. The results show that the factors which contributed to the resilence, as well as the factors which caused damage and functionality loss were difficult to foresee and plan for. The non-structural damage to utilities and suspended ceilings was far more disruptive to the provision of healthcare than the minor structural damage to buildings. The physical damage to the healthcare network reduced the capacity, which has further strained a health care system already under pressure. Providing the already high rate of occupancy prior to the Christchurch earthquake the Canterbury healthcare network has still provided adequate healthcare to the community.
Background: We are in a period of history where natural disasters are increasing in both frequency and severity. They are having widespread impacts on communities, especially on vulnerable communities, those most affected who have the least ability to prepare or respond to a disaster. The ability to assemble and effectively manage Interagency Emergency Response Teams (IERTs) is critical to navigating the complexity and chaos found immediately following disasters. These teams play a crucial role in the multi-sectoral, multi-agency, multi-disciplinary, and inter-organisational response and are vital to ensuring the safety and well-being of vulnerable populations such as the young, aged, and socially and medically disadvantaged in disasters. Communication is key to the smooth operation of these teams. Most studies of the communication in IERTs during a disaster have been focussed at a macro-level of examining larger scale patterns and trends within organisations. Rarely found are micro-level analyses of interpersonal communication at the critical interfaces between collaborating agencies. This study set out to understand the experiences of those working at the interagency interfaces in an IERT set up by the Canterbury District Health Board to respond to the needs of the vulnerable people in the aftermath of the destructive earthquakes that hit Canterbury, New Zealand, in 2010-11. The aim of the study was to gain insights about the complexities of interpersonal communication (micro-level) involved in interagency response coordination and to generate an improved understanding into what stabilises the interagency communication interfaces between those agencies responding to a major disaster. Methods: A qualitative case study research design was employed to investigate how interagency communication interfaces were stabilised at the micro-level (“the case”) in the aftermath of the destructive earthquakes that hit Canterbury in 2010-11 (“the context”). Participant recruitment was undertaken by mapping which agencies were involved within the IERT and approaching representatives from each of these agencies. Data was collected via individual interviews using a semi-structured interview guide and was based on the “Critical Incident Technique”. Subsequently, data was transcribed verbatim and subjected to inductive analysis. This was underpinned theoretically by Weick’s “Interpretive Approach” and supported by Nvivo qualitative data analysis software. Results: 19 participants were interviewed in this study. Out of the inductive analysis emerged two primary themes, each with several sub-factors. The first major theme was destabilising/disruptive factors of interagency communication with five sub-factors, a) conflicting role mandates, b) rigid command structures, c) disruption of established communication structures, d) lack of shared language and understanding, and e) situational awareness disruption. The second major theme stabilising/steadying factors in interagency communication had four sub-factors, a) the establishment of the IERT, b) emergent novel communication strategies, c) establishment of a liaison role and d) pre-existing networks and relationships. Finally, there was a third sub-level identified during inductive analysis, where sub-factors from both primary themes were noted to be uniquely interconnected by emergent “consequences” arising out of the disaster context. Finally, findings were synthesised into a conceptual “Model of Interagency Communication at the Micro-level” based on this case study of the Canterbury earthquake disaster response. Discussion: The three key dimensions of The People, The Connections and The Improvisations served as a framework for the discussion of what stabilises interagency communication interfaces in a major disaster. The People were key to stabilising the interagency interfaces through functioning as a flexible conduit, guiding and navigating communication at the interagency interfaces and improving situational awareness. The Connections provided the collective competence, shared decision-making and prior established relationships that stabilised the micro-level communication at interagency interfaces. And finally, The Improvisations i.e., novel ideas and inventiveness that emerge out of rapidly changing post-disaster environments, also contributed to stabilisation of micro-level communication flows across interagency interfaces in the disaster response. “Command and control” hierarchical structures do provide clear processes and structures for teams working in disasters to follow. However, improvisations and novel solutions are also needed and often emerge from first responders (who are best placed to assess the evolving needs in a disaster where there is a high degree of uncertainty). Conclusion: This study highlights the value of incorporating an interface perspective into any study that seeks to understand the processes of IERTs during disaster responses. It also strengthens the requirement for disaster management frameworks to formally plan for and to allow for the adaptive responsiveness of local teams on the ground, and legitimise and recognise the improvisations of those in the role of emergent boundary spanners in a disaster response. This needs to be in addition to existing formal disaster response mechanisms. This study provides a new conceptual model that can be used to guide future case studies exploring stability at the interfaces of other IERTs and highlights the centrality of communication in the experiences of members of teams in the aftermath of a disaster. Utilising these new perspectives on stabilising communication at the interagency interfaces in disaster responses will have practical implications in the future to better serve the needs of vulnerable people who are at greatest risk of adverse outcomes in a disaster.
